[CT angiography of cerebral venous circulation: anatomical visualization and diagnostic pitfalls in interpretation].
OBJECTIVE
To show the frequency of visualisation of the dural sinuses and cerebral veins with CT-angiography (CTA) with special reference to anatomical variants.


METHODS
34 CTA (1 mm slice thickness, 120 ml nonionic KM, 2 ml/s flow, 40 s prescanning delay) were performed in 30 patients to examine the cerebral venous system. In an anatomic study of cadavers (n = 10) without known disease of the cerebral veins the great sinuses were opened and examined.


RESULTS
The superior sagittal, the transverse, the sigmoid and the straight sinus could be evaluated in all cases (100%). The cortical and deep cerebral veins as well as the small sinuses were visualised in 12-97% of the examinations. A sinovenous thrombosis was diagnosed in 4 of the 30 patients. Asymmetric superior sagittal sinus bifurcation (12/30), a hypoplastic sinus transversus (2/30) and a persistent sinus occipitalis (4/30) were found as anatomical variants. In 10 of the 30 patients we discovered 17 dural sinus filling defects produced by large arachnoid granulations. Similar findings could be demonstrated in the pathologico-anatomic examination series.


CONCLUSIONS
CT angiography is suitable for detailed evaluation of the cerebral veins. Anatomic variants, arachnoid granulations, as well as fibrous bands and septa, which may lead to misinterpretation in conventional CT, can be clearly demonstrated. The sensitivity and specificity of CT in diagnosis of sinovenous thrombosis were increased thereby.
Hünerbein
R
R
Institut für Diagnostische und Inverventionelle Radiologie, Städtische Kliniken Kassel.
Reuter
P
P
Meyer
W
W
Kuhn
F P
FP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002426:Cavernous Sinus / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods*; D002550:Cerebral Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging; D003392:Cranial Sinuses / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
CT-Angiographie des venösen Zerebralkreislaufes: anatomische Darstellbarkeit und Fehlerquellen in der Beurteilung.